Contemporary Clinical Psych 2 Flashcards
One more exception to Informed consent
- if there is info in the file that could lead to locating a missing persion
How long is a patient file kept?
- you have to keep a file for 10 years after the last contact with the person and after that, the file is destroyed
- for a child you keep the file for 10 years after the child turns 18 unless you keep seeing them
Structured diagnostic interview and an example of one
- can remind us of all the different questions we could ask someone
- want to find out of there is a diagnostic category that someone’s experience fits into well
ex: DART
DART
Diagnostic Assessment Research Tool - structured interview for adults
- maps on DSM criteria quite directly
- takes you through the questions
Panic attack
- an abrupt rush of fear and is very physical, reaches a peak within 10-15 mins
- Very unpleasant
- Not dangerous
panic disorder
- at least 1 unexpected panic attack in history
- interpreting a normal body sensation as something extreme and dangerous
What is the next step we can take after knowing someone has a panic disorder?
we can do a further assessment to see what the physical sensations are that might be becoming a problem for the patient
What is a type of intervention we can do to treat panic disorder?
interoceptive exposure
- exposing the patient to the feared body sensation on purpose (psychologist does it too)
- get info from family doctor to be in the clear
ex: spinning in a chair, hyperventilating, running up and down the stairs
in assessment, we can take note of which sensation really caused fear
Body Sensation Questionnaire
- Goes through the body sensations and rate them how afraid they are of them from 1-5.
- Can be compared to a normal group
- Can give it at different times over treatment and see if fear of these body sensations decrease
If you know a client has recently witnessed a loss what can you do if you want to know their feelings?
- deliver a brief grief questionnaire
- we expect an intense period of grief at the beginning and then the intensity decreases over time
- it is common to not want to leave the house, hang out with people, fear of body sensations, relaxing to put off a panic attack
Diagnosis and case conceptualization
provide a diagnosis after assessments
ex: panic disorder with grief (addressed)
NICE: psychological intervention guidelines for panic disorder
CBT
- weekly sessions of 1-2 hours and completed within a max of 4 months of commencement
- 7-14 hours total
NICE: pharmacological intervention guidelines for panic disorder
antidepressant if long-standing and refusal of psychological intervention
SSRI, SNRI, TCA
should be informed of side effects and withdrawal symptoms if stopped abruptly
why would Ativan not be a good intervention for panic disorder?
it’s not an antidepressant - benzodiazapine
- associated with a less good outcome in the long term
- used as a safety behaviour, not addressing the beliefs about the physical sensations, just temporarily changing emotional experience
- very dependent drug
What is an in vivo behavioural experiment?
an experiment out of office
Belief: “If I go to a movie theatre, I will have a panic attack”
Experiment: Go to a movie theatre alone to watch a movie that would have been enjoyed by the client before developing panic disorder (in vivo exposure)
- Can also try hyperventilating while at the movie theatre
What is an example of a behavioral experiment for panic disorder?
Belief: “When I feel lightheaded, it means I am having a stroke”
Experiment: Hyperventilate on purpose to recreate sensation (interoceptive exposure)
- Look out for Jade’s safety-seeking behaviours
